Quadriplegia due to lead-contaminated opium--case report.
OBJECTIVE
Utilization of lead-contaminated opium may lead to severe motor neuron impairment and quadriplegia.


METHODS
Forty years oriented old male, opium addict, was admitted to the ICU, with headache, nausea and abdominal pain, and weakness in his lower and upper extremities without definitive diagnosis. The past medical and occupational history was negative. Laboratory investigation showed; anemia (Hb 7.7 g/dl), slightly elevated liver function tests, elevated total bilirubin, and ESR. Abdominal sonography and brain CT scan were normal. EMG and NCV results and neurologic examination were suggestive for Guillain-Barre. He underwent five sessions of plasmapheresis. Blood lead level was > 200 microg/dl. He received dimercaprol (BAL) and calcium disodium edetate (CaEDTA) for two five days session. Upon discharge from ICU all laboratory tests were normal and blood lead level was reduced, but he was quadriplegic.


CONCLUSIONS
The delayed treatment of lead poisoning may lead to irreversible motor neuron defect.
Beigmohammadi
Mohammad Taghi
MT
Department of Anesthesiology & Intensive Care, Imam Khomeini Hospital, Tehran Univ. of Medical Sciences, Tehran, Iran. mbage46@yahoo.co.uk
Aghdashi
Moosa
M
Najafi
Atabak
A
Mojtahedzadeh
Mojtaba
M
Karvandian
Kassra
K
D000328:Adult; D002614:Chelating Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004112:Dimercaprol / Q000627:therapeutic use; D004340:Drug Contamination; D004492:Edetic Acid / Q000627:therapeutic use; D006801:Humans; D007854:Lead / Q000097:blood; D007855:Lead Poisoning / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D009294:Narcotics / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000150:complications; D009892:Opium / Q000009:adverse effects*; D011782:Quadriplegia / Q000139:chemically induced* / Q000175:diagnosis
D002614:Chelating Agents; D009294:Narcotics; D004112:Dimercaprol; D007854:Lead; D009892:Opium; D004492:Edetic Acid